Center of Evidence-Based Medicine, Institute of Medical Sciences, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, China.
Department of Nuclear Medicine, the Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Sci Rep. 2021 Jan 14;11(1):1348. doi: 10.1038/s41598-020-80015-8.
Our aim was to clarify the optimum pre-ablative thyroid-stimulating hormone (TSH) level for initial radioiodine remnant ablation (RRA) in patients with differentiated thyroid carcinoma (DTC). From December 2015 to May 2019, 689 patients undergone RRA at Nuclear Medicine Department, Second Hospital of Shandong University were included in the study. Patients were categorized by their pre-ablative TSH level grouping of < 30, 30-70 and ≥ 70 mIU/L. Response to RRA were evaluated as complete response (including excellent and indeterminate response) and incomplete response (including biochemical and structural incomplete response) after a follow-up of 6-8 months. Multivariable binary logistic regression model was used to explore the optimum pre-ablative TSH level range and independent factors associated with response to RRA. Rates of complete response to RRA were 63.04%, 74.59% and 66.41% in TSH level groups of < 30, 30-70 and ≥ 70 mIU/L, separately. With multivariate analysis, the study found that pre-ablative TSH levels, gender and lymph node dissection were independent predictors of response to RRA. TSH between 30 and 70 mIU/L had a higher rate of complete response compared with TSH < 30 mIU/L, OR 0.451 (95% CI 0.215-0.958, P = 0.036). A pre-ablative TSH level of 30-70 mIU/L was appropriate for patients with DTC to achieve a better response to RRA.
我们旨在明确分化型甲状腺癌（DTC）患者初始放射性碘残余消融（RRA）前促甲状腺激素（TSH）的最佳水平。2015 年 12 月至 2019 年 5 月，共有 689 例在山东大学第二医院核医学科行 RRA 的患者纳入本研究。根据患者的预消融 TSH 水平分为<30、30-70 和≥70 mIU/L 组。在随访 6-8 个月后，评估 RRA 反应为完全缓解（包括极好和不确定反应）和不完全缓解（包括生化和结构不完全缓解）。采用多变量二项逻辑回归模型探讨最佳预消融 TSH 水平范围和与 RRA 反应相关的独立因素。TSH<30、30-70 和≥70 mIU/L 组的 RRA 完全缓解率分别为 63.04%、74.59%和 66.41%。多因素分析发现，预消融 TSH 水平、性别和淋巴结清扫术是 RRA 反应的独立预测因素。与 TSH<30 mIU/L 相比，TSH 在 30-70 mIU/L 时完全缓解率更高，OR 0.451（95%CI 0.215-0.958，P=0.036）。对于 DTC 患者，30-70 mIU/L 的预消融 TSH 水平可获得更好的 RRA 反应。
